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Double‐ P atch Repair by a Bilateral Ventriculotomy for Postinfarction Ventricular Septal Defect
Author(s) -
Iwaki Ryuma,
Nakagiri Keitaro,
Murakami Hirohisa,
Morimoto Naoto,
Yoshida Masato,
Mukohara Nobuhiko
Publication year - 2014
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12262
Subject(s) - ventriculotomy , medicine , shunt (medical) , cardiology , myocardial infarction , univariate analysis , surgery , retrospective cohort study , ventricle , multivariate analysis
Objectives Repair of a postinfarction ventricular septal defect (VSD) is a challenging procedure with a high risk of postoperative residual shunt and subsequent mortality. This retrospective study aimed to assess a modified infarct exclusion technique with a biventricular approach. Methods Nineteen consecutive patients who underwent the infarct exclusion procedure for VSD between 2002 and 2011 were reviewed. A biventricular approach (B group: 6 patients) and a left ventricular approach (L group: 13 patients) were studied by univariate analysis. Results The overall 30‐day mortality was 15.8%, and was not different between the two groups (p = 0.94). Postoperative residual shunt was not observed in the B group (p = 0.21). The overall five‐year survival rate was 79%, and there were no late deaths in the B group (p = 0.14). Conclusion The repair of postinfarction VSD can be safely performed by the infarct exclusion technique with a biventricular approach. This technique seems to reduce surgical mortality and prevents recurrence of the VSD. doi: 10.1111/jocs.12262 (J Card Surg 2014;29:181–185)